Hearing aid fitting in the elderly: prescription of acoustic gain through frequency thresholds obtained with pure tone and narrow band stimuli.

Dias, Gabriela Fireman Martines; Souza, Marilia Rodrigues Freitas de; Iorio, Maria Cecília Martinelli

doi:10.1590/2317-1782/20202020192

Brasil

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Original Article • CoDAS 33 (6) • 2021 • https://doi.org/10.1590/2317-1782/20202020192 linkcopy

Hearing aid fitting in the elderly: prescription of acoustic gain through frequency thresholds obtained with pure tone and narrow band stimuli.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose To verify the benefit obtained by the prescription of acoustic gain based on the auditory thresholds obtained with pure tones modulated in frequency and with Narrow Band Noise.

Methods The sample consisted of 30 elderly people, aged 60 years or over with moderate to severe descending sensorineural symmetrical hearing loss with thresholds at 4kHz equal to or less than 70dBHL. There were two groups. GTP (pure tone group): 15 elderly people had their hearing aids fitted through the auditory thresholds obtained with pure tone and the GNB group (narrow band group): 15 elderly people had their hearing aids fitted through the auditory thresholds obtained with NB. The procedures performed before the fitting of hearing aids and after three months of amplification use were: COSI, WRS (Word Recognition Score), Signal/Noise ratio. The International Outcome Inventory for Hearing Aids (IOI-HA) was applied only after three months of hearing aid fitting.

Results The elderly people in the group in which the hearing aids were fitted with a prescribed gain based on the hearing thresholds obtained with the Narrow Band stimulus showed better performance in the following tests: WRS on the right ear, total score of the IOI-HA inventory, COSI and longer use of hearing aids compared to the GTP group.

Conclusion There was a greater benefit with the use of hearing aids, due to the total score of the IOI-HA inventory, COSI scale and longer daily use time of hearing aids, in the group whose prescription of acoustic gain was based on the auditory thresholds obtained with narrow band.

Keywords Aging; Aged; Hearing Aids; Auditory Threshold; Hearing Loss

Variable	Group	Average	SD	Median	Min.	Max.	p	E.S.
Threshold – PT– 250 Hz (dBHL)RE	GTP	31.33 [25.33. 37.33]	12.74	30.00 [20.00. 40.00]	15.00	50.00	0.873^a	0.052^d
Threshold – PT– 250 Hz (dBHL)RE	GNB	30.67 [26.33. 34.33]	9.61	35.00 [25.00. 40.00]	10.00	45.00	0.873^a	0.052^d
Threshold – PT– 500 Hz (dBHL)RE	GTP	34.67 [28.67. 41.00]	13.16	35.00 [30.00. 40.00]	10.00	55.00	0.384^a	0.304^d
Threshold – PT– 500 Hz (dBHL)RE	GNB	38.67 [33.33. 43.80]	11.57	40.00 [35.00. 50.00]	15.00	50.00	0.384^a	0.304^d
Threshold – PT– 1000 Hz (dBHL)RE	GTP	40.67 [34.33. 46.67]	12.80	45.00 [40.00. 45.00]	15.00	60.00	0.079^a	0.599^d
Threshold – PT– 1000 Hz (dBHL)RE	GNB	48.33 [43.33. 53.00]	10.12	50.00 [50.00. 50.00]	30.00	60.00	0.079^a	0.599^d
Threshold – PT– 2000 Hz (dBHL)RE	GTP	49.33 [42.65. 55.67]	11.93	50.00 [45.00. 50.00]	25.00	65.00	0.003*^a	0.978^d
Threshold – PT– 2000 Hz (dBHL)RE	GNB	61.00 [57.33. 64.33]	7.12	65.00 [65.00. 65.00]	45.00	70.00	0.003*^a	0.978^d
Threshold – PT – 3000 Hz (dBHL)RE	GTP	56.67 [53.67. 60.00]	6.99	60.00 [60.00. 60.00]	45.00	70.00	0.073^a	0.763^d
Threshold – PT – 3000 Hz (dBHL)RE	GNB	62.00 [57.00. 66.33]	8.62	65.00 [65.00. 65.00]	40.00	75.00	0.073^a	0.763^d
Threshold – PT – 4000 Hz (dBHL)RE	GTP	60.67 [56.33. 64.67]	8.21	60.00 [60.00. 60.00]	45.00	70.00	0.231^a	0.406^d
Threshold – PT – 4000 Hz (dBHL)RE	GNB	64.00 [61.00. 67.33]	6.60	65.00 [60.00. 65.00]	55.00	75.00	0.231^a	0.406^d
Threshold – PT– 6000 Hz (dBHL)RE	GTP	69.67 [64.67. 75.33]	10.93	75.00 [60.00. 75.00]	55.00	90.00	0.559^a	0.213^d
Threshold – PT– 6000 Hz (dBHL)RE	GNB	72.00 [67.00. 77.00]	10.66	70.00 [65.00. 75.00]	50.00	90.00	0.559^a	0.213^d
Threshold – –PT 8000 Hz (dBHL)RE	GTP	77.67 [70.00. 86.33]	16.24	70.00 [70.00. 90.00]	55.00	110.00	0.525^a	0.205^d
Threshold – –PT 8000 Hz (dBHL)RE	GNB	74.33	11.78	70.00 [70.00. 85.00]	55.00	100.00	0.525^a	0.205^d
Threshold – NB – 250 Hz (dBHL)RE	GTP	27.33 [22.67. 31.67]	10.33	25.00 [20.00. 35.00]	10.00	40.00	0.548^a	0.226^d
Threshold – NB – 250 Hz (dBHL)RE	GNB	25.00 [20.33. 29.33]	10.69	25.00 [25.00. 25.00]	5.00	45.00	0.548^a	0.226^d
Threshold – NB – 500 Hz (dBHL)RE	GTP	28.67 [22.67. 35.33]	13.16	25.00 [20.00. 35.00]	5.00	50.00	0.368^a	0.304^d
Threshold – NB – 500 Hz (dBHL)RE	GNB	32.67 [27.67. 37.33]	10.67	35.00 [35.00. 35.00]	15.00	45.00	0.368^a	0.304^d
Threshold – NB – 1000 Hz (dBHL)RE	GTP	32.67 [27.67. 37.67]	10.50	35.00 [25.00. 35.00]	15.00	50.00	0.001*^b	0.605^r
Threshold – NB – 1000 Hz (dBHL)RE	GNB	43.00 [38.00. 47.67]	10.66	45.00 [45.00. 45.00]	25.00	55.00	0.001*^b	0.605^r
Threshold – NB – 2000 Hz (dBHL)RE	GTP	40.33 [35.00. 45.33]	9.72	40.00 [40.00. 40.00]	20.00	55.00	0.002*^a	1.029^d
Threshold – NB – 2000 Hz (dBHL)RE	GNB	50.33 [48.00. 52.67]	5.81	50.00 [50.00. 50.00]	40.00	60.00	0.002*^a	1.029^d
Threshold – NB – 3000 Hz (dBHL)RE	GTP	46.67 [44.33. 49.00]	5.23	45.00 [45.00. 50.00]	40.00	55.00	0.013*^a	1.147^d
Threshold – NB – 3000 Hz (dBHL)RE	GNB	52.67 [49.00. 56.00]	7.04	50.00 [50.00. 60.00]	35.00	60.00	0.013*^a	1.147^d
Threshold – NB – 4000 Hz (dBHL)RE	GTP	51.33 [47.67. 54.67]	7.43	50.00 [50.00. 50.00]	40.00	60.00	< 0.001*^b	0.653^r
Threshold – NB – 4000 Hz (dBHL)RE	GNB	56.00 [52.67. 59.00]	7.12	55.00 [55.00. 55.00]	40.00	70.00	< 0.001*^b	0.653^r
Threshold – NB – 6000 Hz (dBHL)RE	GTP	59.00 [54.67. 63.67]	8.90	60.00 [60.00. 60.00]	45.00	75.00	0.852^a	0.075^d
Threshold – NB – 6000 Hz (dBHL)RE	GNB	59.67 [54.67. 64.33]	10.43	60.00 [60.00. 60.00]	35.00	75.00	0.852^a	0.075^d
Threshold – NB – 8000 Hz (dBHL)RE	GTP	62.33 [58.67. 66.33]	7.99	60.00 [60.00. 60.00]	50.00	80.00	0.989^b	0.004^r
Threshold – NB – 8000 Hz (dBHL)RE	GNB	58.67 [52.33. 64.33]	11.87	65.00 [65.00. 65.00]	35.00	75.00	0.989^b	0.004^r
Threshold – PT – 250 Hz (dBHL)LE	GTP	32.00 [26.67. 37.67]	11.62	30.00 [30.00. 30.00]	15.00	55.00	0.755^a	0.115^d
Threshold – PT – 250 Hz (dBHL)LE	GNB	33.33 [26.33. 39.11]	11.60	35.00 [30.00. 40.00]	5.00	50.00	0.755^a	0.115^d
Threshold – PT – 500 Hz (dBHL)LE	GTP	35.33 [29.67. 41.33]	12.02	35.00 [35.00. 35.00]	15.00	60.00	0.320^a	0.360^d
Threshold – PT – 500 Hz (dBHL)LE	GNB	39.67 [34.00. 46.00]	11.41	40.00 [30.00. 45.00]	25.00	60.00	0.320^a	0.360^d
Threshold – PT – 1000 Hz (dBHL)LE	GTP	40.67 [33.67. 47.33]	13.35	40.00 [35.00. 45.00]	15.00	65.00	0.003*^a	0.974^d
Threshold – PT – 1000 Hz (dBHL)LE	GNB	53.67 [50.21. 57.00]	7.90	55.00 [55.00. 55.00]	40.00	65.00	0.003*^a	0.974^d
Threshold – PT – 2000 Hz (dBHL)LE	GTP	52.67 [48.77. 56.67]	9.61	50.00 [45.00. 55.00]	40.00	75.00	0.007*^a	0.867^d
Threshold – PT – 2000 Hz (dBHL)LE	GNB	61.00 [58.33. 63.67]	5.41	60.00 [60.00. 65.00]	50.00	70.00	0.007*^a	0.867^d
Threshold – PT – 3000 Hz (dBHL)LE	GTP	58.00 [55.23. 61.00]	7.02	60.00 [50.00. 65.00]	45.00	70.00	0.110^a	0.570^d
Threshold – PT – 3000 Hz (dBHL)LE	GNB	62.00 [59.00. 65.00]	6.21	65.00 [55.00. 70.00]	50.00	70.00	0.110^a	0.570^d
Threshold – PT – 4000 Hz (dBHL)LE	GTP	62.67 [60.00. 65.33]	6.23	60.00 [60.00. 70.00]	55.00	70.00	0.253^b	0.217^r
Threshold – PT – 4000 Hz (dBHL)LE	GNB	65.33 [63.33. 67.33]	4.81	65.00 [65.00. 65.00]	55.00	70.00	0.253^b	0.217^r
Threshold – PT – 6000 Hz (dBHL)LE	GTP	68.33 [62.67. 74.00]	11.44	65.00 [60.00. 75.00]	50.00	90.00	0.252^a	0.379^d
Threshold – PT – 6000 Hz (dBHL)LE	GNB	72.67 [69.00. 76.67]	8.63	70.00 [70.00. 75.00]	60.00	95.00	0.252^a	0.379^d
Threshold – PT – 8000 Hz (dBHL)LE	GTP	76.33 [69.33. 84.00]	14.82	75.00 [65.00. 85.00]	55.00	105.00	0.561^a	0.202^d
Threshold – PT – 8000 Hz (dBHL)LE	GNB	73.33 [67.33. 79.33]	13.05	70.00 [70.00. 70.00]	50.00	100.00	0.561^a	0.202^d
Threshold – NB – 250 Hz (dBHL)LE	GTP	23.33 [18.00. 29.00]	12.20	20.00 [15.00. 20.00]	10.00	50.00	0.284^b	0.199^r
Threshold – NB – 250 Hz (dBHL)LE	GNB	26.67 [19.67. 33.33]	12.34	25.00 [25.00. 25.00]	.00	45.00	0.284^b	0.199^r
Threshold – NB – 500 Hz (dBHL)LE	GTP	27.00 [20.67. 33.67]	13.34	25.00 [25.00. 25.00]	5.00	55.00	0.152^a	0.525^d
Threshold – NB – 500 Hz (dBHL)LE	GNB	34.00 [27.33. 40.52]	12.71	35.00 [30.00. 35.00]	15.00	55.00	0.152^a	0.525^d
Threshold – NB – 1000 Hz (dBHL)LE	GTP	31.00 [25.00. 37.33]	12.56	30.00 [30.00. 30.00]	10.00	60.00	0.001*^a	1.141^d
Threshold – NB – 1000 Hz (dBHL)LE	GNB	45.33 [41.67. 49.00]	8.12	45.00 [40.00. 45.00]	35.00	60.00	0.001*^a	1.141^d
Threshold – NB – 2000 Hz (dBHL)LE	GTP	41.00 [37.33. 44.67]	8.06	40.00 [40.00. 40.00]	25.00	60.00	< 0.001^* * Statistically significant value at the 5% level (p ≤ 0.05) ^a	1.736^d
Threshold – NB – 2000 Hz (dBHL)LE	GNB	55.00 [52.33. 58.00]	5.98	55.00 [55.00. 55.00]	45.00	65.00		1.736^d
Threshold – NB – 3000 Hz (dBHL)LE	GTP	45.67 [43.33. 48.00]	5.30	45.00 [45.00. 45.00]	40.00	55.00	< 0.001*^b	0.634^r
Threshold – NB – 3000 Hz (dBHL)LE	GNB	54.33 [52.00. 56.67]	5.30	55.00 [55.00. 55.00]	45.00	60.00	< 0.001*^b	0.634^r
Threshold – NB – 4000 Hz (dBHL)LE	GTP	50.67 [47.67. 53.67]	7.04	50.00 [50.00. 50.00]	40.00	60.00	< 0.001*^b	0.653^r
Threshold – NB – 4000 Hz (dBHL)LE	GNB	61.00 [59.00. 63.00]	4.71	60.00 [60.00. 60.00]	55.00	70.00	< 0.001*^b	0.653^r
Threshold – NB – 6000 Hz (dBHL)LE	GTP	57.33 [53.33. 61.67]	8.63	55.00 [50.00. 60.00]	45.00	75.00	0.267^a	0.425^d
Threshold – NB – 6000 Hz (dBHL)LE	GNB	61.00 [57.00. 65.33]]	9.10	60.00 [60.00. 60.00]	50.00	85.00	0.267^a	0.425^d
Threshold – NB – 8000 Hz (dBHL)LE	GTP	62.00 [58.67. 65.67]	8.41	60.00 [60.00. 60.00]	50.00	80.00	0.776^a	0.119^d
Threshold – NB – 8000 Hz (dBHL)LE	GNB	61.00 [56.33. 65.67]	10.56	65.00 [65.00. 65.00]	45.00	80.00	0.776^a	0.119^d

Variable	Group	Average	SD	Median	Min.	Max.	p^c	E.S.
WRS– RE (%)	GTP	74.67 [69.60. 79.47]	11.38	76.00 [72.00. 80.00]	48.00	88.00	0.029*	0.797
WRS– RE (%)	GNB	65.60 [60.43. 70.67]	10.23	68.00 [56.00. 72.00]	44.00	80.00	0.029*	0.797
WRS – LE (%)	GTP	74.20 [69.39. 79.15]	10.72	72.00 [68.00. 80.00]	60.00	92.00	0.077	0.628
WRS – LE (%)	GNB	67.47 [62.67. 72.03]	9.30	68.00 [68.00. 68.00]	48.00	80.00	0.077	0.628

Variable	Group	Average	SD	Median	Min.	Max.	p	E.S.
DL - RE (hours/day)	GTP	8.13 [6.53. 9.53]	3.03	9.00 [9.00. 9.00]	3.00	13.00	0.049*^a	0.685
DL - RE (hours/day)	GNB	10.20 [9.07. 11.33]	2.46	10.00 [8.00. 12.00]	7.00	14.00	0.049*^a	0.685
DL - LE (hours/day)	GTP	8.73 [7.12. 10.20]	2.80	9.00 [8.00. 11.00]	4.00	13.00	0.191^a	0.455
DL - LE (hours/day)	GNB	10.00 [8.93. 11.13]	2.39	10.00 [10.00. 10.00]	6.00	14.00	0.191^a	0.455
COSI scale	GTP	8.00 [7.47. 8.60]	1.41	8.00 [7.00. 10.00]	6.00	10.00	0.044*^b	0.374^r
COSI scale	GNB	9.00 [8.60. 9.33]	.93	9.00 [9.00. 9.00]	7.00	10.00	0.044*^b	0.374^r
List 1B (S/R ratio)	GTP	5.52 [1.08. 9.58]	9.46	7.60 [5.00. 9.00]	-16.00	20.00	0.127^a	0.474
List 1B (S/R ratio)	GNB	10.00 [6.96. 12.71]	5.65	12.30 [8.00. 13.60]	-2.00	17.20	0.127^a	0.474
List 2B (S/R ratio)	GTP	3.24 [-0.96. 6.82]	7.70	6.20 [4.50. 7.40]	-15.00	12.00	0.151^b	0.265^r
List 2B (S/R ratio)	GNB	7.12 [3.93. 9.38]	5.29	7.60 [6.00. 10.00]	-9.00	12.80	0.151^b	0.265^r

GTP				GNB
Complaint	Occurrence of the complaint		Average of perceived improvement	Complaint	Occurrence of the complaint		Average of perceived improvement
	N	%	%		N	%	%
TV	14	93.33	93.57	TV	9	60.00	95.00
Telephone	7	46.67	89.29	Telephone	8	53.33	86.88
Listening in noise	6	40.00	70.00	Group chat	7	46.67	95.00
Understanding speech	4	26.67	73.75	Listening in noise	5	33.33	79.00
Talking	4	26.67	73.75	Church	3	20.00	88.33
Buzz	4	26.67	72.50	Understanding speech	3	20.00	95.00
Group chat	4	26.67	67.50	Buzz	2	13.33	95.00
Church	3	20.00	65.00	Location	2	13.33	95.00
Location	2	13.33	95.00	Individual conversation	2	13.33	95.00
Watching TV and someone calls	1	6.67	75.00	Noisy environment	1	6.67	75.00
Lectures	1	6.67	75.00	Understanding people	1	6.67	95.00
Hearing conversations	1	6.67	50.00	Talking with people	1	6.67	95.00
Hearing people with their backs turned	1	6.67	75.00	Talking with people	1	6.67	75.00
Hearing street sounds	1	6.67	95.00	Family parties	1	6.67	95.00
Dizziness	1	6.67	50.00	Hearing	1	6.67	75.00
Annoyance of people	1	6.67	95.00	Long-distance understanding	1	6.67	50.00
Hearing the sounds of nature	1	6.67	95.00	Understanding conversations	1	6.67	95.00
Stop getting closer to people to listen	1	6.67	95.00
Annoyance in a noisy place	1	6.67	75.00
Hearing two things at once	1	6.67	25.00
Decrease repeat request in conversations	1	6.67	75.00
Hearing environmental sounds	1	6.67	95.00

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[1] p: statistical significance, Student t-test for independent samples (^a), Mann-Whitney U-test (^b), effect size for comparison between two groups according to Cohen, 1992 (^d), effect size for comparison between two groups according to Rosenthal, 1991 (^r),

[TFN100] ^*
Statistically significant value at the 5% level (p ≤ 0.05)

[3] Caption: GTP = Tone Pure Group; GNB = Narrow Band Group; RE: Right Ear; LE: Left Ear; PT: Pure tone; NB: Narrowband; SD: Standard deviation; Min.: Minimum; Max: Maximum; E.S.: Effect size

Question	Group	Median	Min.	Q1	Q3	Max.	p	E.S.
1	GTP	5.00 [5.00. 5.00]	4.00	5.00	5.00	5.00	0.483	0.263
1	GNB	5.00 [5.00. 5.00]	5.00	5.00	5.00	5.00	0.483	0.263
2	GTP	5.00 [5.00. 5.00]	4.00	4.00	5.00	5.00	0.215	0.265
2	GNB	5.00 [5.00. 5.00]	3.00	5.00	5.00	5.00	0.215	0.265
3	GTP	4.00 [4.00. 5.00]	3.00	4.00	5.00	5.00	0.216	0.261
3	GNB	5.00 [5.00. 5.00]	3.00	4.00	5.00	5.00	0.216	0.261
4	GTP	5.00 [5.00. 5.00]	3.00	5.00	5.00	5.00	> 0.999	0.000
4	GNB	5.00 [5.00. 5.00]	3.00	5.00	5.00	5.00	> 0.999	0.000
5	GTP	5.00 [5.00. 5.00]	3.00	5.00	5.00	5.00	0.732	0.099
5	GNB	5.00 [5.00. 5.00]	4.00	5.00	5.00	5.00	0.732	0.099
6	GTP	5.00 [5.00. 5.00]	2.00	4.00	5.00	5.00	0.100	0.385
6	GNB	5.00 [5.00. 5.00]	5.00	5.00	5.00	5.00	0.100	0.385
7	GTP	4.00 [3.00. 5.00]	2.00	2.00	5.00	5.00	0.411	0.162
7	GNB	4.00 [4.00. 4.00]	2.00	3.00	5.00	5.00	0.411	0.162
8	GTP	3.00 [3.00. 3.00]	1.00	1.00	3.00	3.00	0.399	0.184
8	GNB	2.00 [1.00. 3.00]	1.00	1.00	3.00	3.00	0.399	0.184
Score Total	GTP	31.00 [31.00.33.00]	27.00	-	-	35.00	0.027*	0.401
Score Total	GNB	34.00 [34.00.34.00]	27.00	-	-	35.00	0.027*	0.401